WHAT IS THE DIFFERENCE BETWEEN CATARACT SURGERY AND LASIK?

At Focal Point Vision, our ophthalmologists, or eye surgeons, are fellowship-trained and perform both cataract and LASIK surgery. Often during the discussion of cataract surgery, a patient asks, “are you going to be doing LASIK on my eyes? What is the difference between cataract surgery and LASIK?”

Essentially, cataract surgery involves removal of the lens and placement of an artificial lens while LASIK involves reshaping of the cornea.

Before we discuss the nuances of each procedure, it is important to review the basic anatomy of the eye. As you can see in the picture below, the cornea is the clear, spherical “front” of the eye, analogous to the windshield of the car.  Behind the cornea is the iris, or colored part of the eye that can open and close depending on the amount of ambient light, and behind the iris is the lens.  The cornea and lens focus light to land on the retina, which works like the film in a camera, changing light into nerve impulses that travel to the brain.

 

Thus, we’re born with a clear crystalline lens that works very well when we are young, expanding and contracting to see both far and near without reading glasses.  Around the age of 45, the lens becomes more rigid and harder to flex, necessitating reading glasses.  As the number of birthday candles increases, the lens gets more rigid and cloudy, and when it becomes mostly cloudy, we call it a cataract. Cataract surgery is an exchange of the cloudy, dysfunctional natural lens with an artificial lens made of acrylic.

On the other hand, LASIK is eye surgery in which we use a laser to reshape the cornea and eliminate the need for glasses or contacts.

Again, cataract surgery involves exchange of the lens, while LASIK involves reshaping the cornea. Both procedures can change somebody’s refractive error, or “prescription,” and lessen the need for reading glasses.

LASIK is commonly performed in patients between the age of 20 – 40, while cataract surgery is more often performed in patients above the age of 55.

Over the past few years, we have started to use a LASIK femtosecond laser at the time of cataract surgery to make incisions, divide the cataract, and treat astigmatism. This is called “laser cataract surgery,” and we will address this in future posts.  Thanks!  James Lehmann, MD.

LIVE LIFE NOW WITH LASIK AND FACE YOUR #FOMO!

Angle closure glaucoma is a serious condition that can, if untreated, lead to permanent vision loss and even blindness. Patients who are at risk for this type of glaucoma have “narrow angles,” meaning the front fluid-filled compartment of the eye is particularly small. Such patients are often far-sighted, or “hyperopic” and at least 1/3 have a family history of a close relative with the condition.

An episode of “acute angle closure” in a patient like this can cause rapid elevation of the pressure inside the eye, with symptoms of a headache, eye pain, eye redness, blurred vision, nausea, and vomiting. Any person with these symptoms should alert an eye care professional as soon as possible, since prolonged elevation of eye pressure can cause severe and permanent damage to the eye.

Focal Point Vision doctors always assess the risk of angle closure glaucoma for each new patient they see, utilizing a variety of tools including special prisms called gonioscopy lenses and an imaging device called an anterior segment optical coherence tomographer (ASOCT). These examination tools help our doctors determine which patients might benefit from a preventative laser procedure known as Laser Peripheral Iridotomy (LPI).

Any patient having an “acute angle closure” episode, and those patients at high risk for such an episode, should have LPI performed. The procedure is done quickly in the office with minimal discomfort, excellent success rate, and extremely low risk to the patient. The laser procedure essentially removes the future risk of angle closure episodes, and should be performed on both eyes, since patients with narrow angles are typically at risk for glaucoma in both eyes. Narrow angle patients who also have cataracts are sometimes treated with cataract surgery, which eliminates the risk of angle closure glaucoma, and improves the vision at the same time.

Don’t hesitate to call 210-614-3600 and make an appointment with the doctors at Focal Point Vision if you or someone you love may have a risk of angle closure glaucoma.